Hadayer Noa, Ramot Yuval, Maly Alexander, Zlotogorski Abraham
Department of Dermatology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
Department of Pathology, Hadassah-Hebrew University Medical Center, Jerusalem,, Israel.
Int J Trichology. 2013 Jul;5(3):157-8. doi: 10.4103/0974-7753.125618.
Pemphigus vulgaris is an autoimmune disease, which leads to flaccid bullae and erosions. Although the scalp is commonly involved, hair loss is rarely seen. We herein report a case of 32-year-old female patient with a 2-year history of pemphigus vulgaris, involving the skin and mucosa. Although clinical improvement was achieved with oral corticosteroids and mycophenolate mofetil, the patient developed tender plaques on her scalp, accompanied by hair loss. Histopathology and direct immunofluorescence were consistent with pemphigus vulgaris. Skin swab cultured Staphylococcus aureus. Treatment with oral and topical corticosteroids combined with mycophenolate mofetil resulted in clinical remission, with regrowth of scalp hair. Alopecia is an unusual clinical manifestation of pemphigus vulgaris. Our case supports the hypothesis that hair loss is induced by antibody-mediated outer root sheath keratinocyte acantholysis, in combination with skin infection, that together lead to the observed hair loss.
寻常型天疱疮是一种自身免疫性疾病，可导致松弛性水疱和糜烂。虽然头皮常受累，但脱发很少见。我们在此报告一例32岁女性寻常型天疱疮患者，病史2年，累及皮肤和黏膜。虽然口服皮质类固醇和霉酚酸酯使病情得到临床改善，但患者头皮出现压痛性斑块，并伴有脱发。组织病理学和直接免疫荧光检查结果与寻常型天疱疮一致。皮肤拭子培养出金黄色葡萄球菌。口服和外用皮质类固醇联合霉酚酸酯治疗使病情临床缓解，头皮毛发再生。脱发是寻常型天疱疮一种不寻常的临床表现。我们的病例支持这样一种假说，即脱发是由抗体介导的外根鞘角质形成细胞棘层松解，加上皮肤感染共同导致的。
